Related Experiment Videos
Infection with hepatitis G virus among recipients of plasma products
L M Jarvis1, F Davidson, J P Hanley
1Department of Medical Microbiology, University of Edinburgh, UK.
Background:
Hepatitis G virus (HGV or GBV-C) is a newly discovered human flavivirus distantly related to hepatitis C virus (HCV). Little information is available on its natural history or routes of transmission, although it can be transmitted parenterally. We investigated the prevalence of persistent infection of HGV and HCV in patients exposed to non-virus-inactivated pooled blood products associated with transmission of HCV.
Methods:
RNA was extracted from the plasma of 112 patients with haemophilia and 57 with hypogammaglobulinaemia, as well as from 64 different batches of archived coagulation-factor concentrates and immunoglobulins. RNA was reverse transcribed and amplified with primers from the 5' non-coding region of HCV and HGV by a nested polymerase chain reaction (PCR). Viral RNA was quantified by titration of complementary DNA before amplification.
Findings:
Among non-renumerated UK blood donors HGV infection (detected by PCR) was more common than HCV infection (four [3.2%] of 125 compared with 137 [0.076%] of 180658 in southeast Scotland). Testing of batches of factor VIII and factor IX concentrates prepared without viral inactivation procedures showed high frequencies of contamination with HGV (16 of 17 factor VIII batches positive; six of six factor IX batches positive), with no difference between renumerated and non-renumerated donors. However, among 95 haemophiliacs who had received non-virus-inactivated concentrates, 13 (14%) were positive for HGV compared with 79 (83%) who were positive for HCV. Two of 37 recipients of long-term immunoglobulin replacement therapy were positive for HGV. Virus inactivation of blood products substantially reduced or eliminated contamination by HGV RNA sequences.
Interpretation:
Despite the extremely high level of HGV contamination of non-virus-inactivated blood products, their use was not associated with high rates of persistent infection in recipients. The infectivity of HGV in blood products may be lower than that of HCV, or the virus may be less able to establish persistent infection in humans. Whatever the case, the high prevalence of active HGV infection in the general population remains difficult to explain.
Insights
Hepatitis G virus (HGV) was highly prevalent in blood products but did not lead to high persistent infection rates in recipients. This suggests HGV may be less infectious than Hepatitis C virus (HCV) in blood transfusions.
Area of Science:
- Virology
- Hepatology
- Infectious Diseases
Background:
- Hepatitis G virus (HGV), also known as GB-C, is a newly identified flavivirus related to Hepatitis C virus (HCV).
- Limited data exists on HGV's natural history and transmission routes, though parenteral transmission is known.
- This study investigated HGV and HCV infection prevalence in patients exposed to non-virus-inactivated blood products linked to HCV transmission.
Purpose of the Study:
- To determine the prevalence of persistent Hepatitis G virus (HGV) and Hepatitis C virus (HCV) infections.
- To assess the risk of HGV and HCV transmission through non-virus-inactivated pooled blood products.
- To compare the infectivity and persistence of HGV versus HCV in recipients of blood products.
Main Methods:
- Plasma samples from 112 hemophiliacs and 57 hypogammaglobulinemia patients were analyzed.
- Sixty-four batches of archived coagulation factors and immunoglobulins were tested for viral RNA.
- Nested polymerase chain reaction (PCR) was used to detect and amplify HCV and HGV RNA from extracted RNA.
Main Results:
- HGV infection was more common in UK blood donors (3.2%) than HCV (0.076%).
- Non-virus-inactivated factor VIII and IX concentrates showed high HGV contamination rates (87.5% and 100% respectively).
- Among recipients of non-virus-inactivated concentrates, 14% had HGV compared to 83% with HCV; 4.7% of immunoglobulin recipients had HGV.
Conclusions:
- Despite high HGV contamination in blood products, persistent infection rates in recipients were not elevated.
- HGV's infectivity via blood products may be lower than HCV, or it may establish infection less readily.
- The high prevalence of active HGV infection in the general population remains unexplained by blood product transmission alone.